Objective To evaluate the therapeutic effect of half ring sculcus external fixation after failed internal fixation of tibial fracture.  Methods Sixty-five cases of tibial fractures after failed internal fixation during the past 15 years were analyzed retrospectively. Among them

42 cases were fixed with plate and screws

11 with screws and wires

6 with intramedullary nails

and 6 with screws. Inadequate soft tissue coverage occurred in 32 cases and infection in 62 cases. All internal fixators were removed and re-fixed with half ring sculcus external fixator. For 32 cases with soft tissue defect

10 were repaired with gastrocnemius musculocutaneous flap

6 with medial head of gastrocnemius and 16 with fascial flap.  Results Forty-nine out of 65 patients healed in the first term (75%). Fracture healing time was 4 to 8 months (5.9 months in average).  Conclusion The half ring sculcus external fixation is effective in treatment of tibial fracture after failed internal fixation.